GNB health center is shining star in community care

The center employs 24 doctors, 279 workers, and serves about 26,000 patients with a "one-stop shopping" approach that has expanded in the last three years to include geriatrics and women's health.

NATALIE SHERMAN

NEW BEDFORD — On Friday, the CEO of the Greater New Bedford Community Health Center opened a cabinet in his third-floor office and withdrew yellowed board minutes from a different time.

In 1981, two doctors worked out of a 2,000-square-foot office on Purchase Street, serving 850 patients with a $250,000 budget. Today, the health center occupies almost the entire block, employs 24 doctors, 279 workers, and serves about 26,000 patients with a "one-stop shopping" approach that has expanded in the last three years to include geriatrics, women's health and a new site on Caroline Street.

Much of the community health center's growth has occurred over the last decade, and reflects the broader move of community health centers from the periphery of the health care system, a place for the poor and uninsured, into the mainstream of medical care.

"I think a lot of the perception of the people with private health care is that we're a poor man's clinic. That's changed. That's changing," CEO Peter Georgeopoulos said. "This is a community health center but you feel you're treated with respect."

"It's really a totally different place and it's changed the perspective from being a clinic into a health center," Board member Larry Finnerty said, adding: "There's a lot of changes out there. ... The Health Center is primed, I think, to play a very large role in supporting the health care initiatives that are in the area."

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Community health centers, which receive federal and state support, provide primary care services to anyone who walks in, regardless of their ability to pay. Patients get charged on a sliding scale based on income. In fiscal 2011, the Greater New Bedford Community Health Center gave away $2 million in medical services, according to an audit.

Long recognized as critical health care providers in vulnerable communities, community health centers have seen a rising number of patients in recent years, a demand spurred by rising health costs, economic downturn and the expansion of public health benefits, particularly in Massachusetts.

According to the Massachusetts League of Community Health Centers, one out of eight residents in the state received care from community health centers. In New Bedford, about 26,000 patients cycled through the community health clinic in 2011, more than a quarter of the city's population.

"The whole tenor of people's attitudes toward a community health center has changed," said board vice president Eleanor Lewis. "There will always be a population that needs to be serviced by it, but you're also seeing the other (privately insured patients). The face has definitely changed from the way that it used to be."

Policy makers have responded to the demand and encouraged expansion, pointing to community health care centers as models for places that serve all patients, while holding down costs.

George W. Bush doubled funding for community health centers during his presidency, and President Obama has continued that approach: reserving $2 billion for them in federal stimulus funds and almost $11 billion in the Affordable Care Act, which officially goes into effect Jan. 1.

Under Georgeopoulos, a Lowell native who started as its vice president and CFO in 1990, the Greater New Bedford Community Health Center has proved adept at tapping into those funds, winning about $9 million in grants, including $6 million for its renovation and expansion projects.

The improvement to the facilities has fed the center's success, at once creating a more upscale feel, while allowing it to add services so that a patient can report to a doctor, drop off an obese child at the wellness center, pick up a prescription and browse eyeglasses all in the same, shiny-floored place.

The centralization of services, long a hallmark of community health centers, appeals to patients and makes for better care, said Georgeopoulos, who looked after his aging father for 15 years and speaks with passion about the importance of easing logistics for patients and their families.

"It's very difficult to be a caretaker," he said. "You've got to be referred here, you've got to go to the pharmacy, all that stuff is available here. ... We've tried to make ourselves user-friendly."

The approach, he said, pays off: After bringing mammography in-house three years ago, 80 percent of patients referred for services followed up, compared to just 20 percent before.

"That speaks for itself," he said.

As at other community health centers, doctors at the GNBCHC do not work on a fee-for-service mode, but receive a salary. Patients who need more specialized, expensive procedures are often referred elsewhere.

Compensation is also lower: In fiscal 2011, Georgeopoulos was the health center's highest-paid employee with a roughly $213,000 salary including benefits, followed by a doctor earning about $178,000.

In fiscal 2011, by comparison, then Southcoast Health System President John Day earned about $1.1 million followed by Southcoast Hospitals CEO Keith Hovan at about $850,000.

Even compared to other community health centers, however, the record of the GNBCHC is remarkable.

Since 2010, the GNBCHC's revenue has grown by about $3 million, to $18 million, even as expenses shrank to $13.4 million from $15 million. (About 20 percent of the roughly $16 million operating budget was drawn from state and federal funds in 2011, according to an audit from that year.)

In 2012, its cost per patient was $616, about half the average of all community health centers in the state, and it outperforms the national average of community health centers when it comes to measurements that look at the quality of patient care. In 2011, for example, 60 percent of children under the age of 2 received the recommended vaccines compared to 40 percent nationwide.

This summer, the center received the results of a 19-point federal review that looked at how well it meets federal requirements, everything from serving its patients to its finances. GNBCHC not only met all the requirements, but in most cases the reviewing team did not even have suggestions for improvement.

"Anybody that lives in New Bedford should be very proud," said Georgeopoulos.

Asked repeatedly, in different ways, how he achieved those results, Georgeopoulos pointed to its patient-centered approach and an experienced staff — the average employee has worked there for 15 years — that works hard: "We all walk and chew gum at the same time."

"I don't know how I do it," he added later. "I say a lot of times, 'God helps.'"

The community health center's board of directors will meet next month to develop a strategic plan for the place.

Right now, new patients must wait three months for an appointment — "too long" — a problem that Georgeopoulos said he hopes to change by adding clinic hours and placing additional, smaller sites in at-risk neighborhoods. Collaborations that already exist with other health providers, such as St. Luke's, also need to grow deeper, he said.

Health care reform has introduced uncertainty and added complicated layers of bureaucracy, Georgeopoulos said, responding with hesitation when asked if he thought it would push other health providers to look more like his.

"I hope so, but it is — all I know is I've been blessed to work here," he said. "Everybody in here is sold on the cause."